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Placental abruption and neonatal anemia

Journal of Perinatology volume 43, pages 782–786 (2023)Cite this article

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Abstract

Objective

Placental abruption can cause maternal blood loss and maternal anemia. It is less certain whether abruption can cause fetal blood loss and neonatal anemia.

Study design

Retrospective multi-hospital 24-month analysis of women with placental abruption and their neonates.

Results

Of 55,111 births, 678 (1.2%) had confirmed abruption; 83% of these neonates (564) had one or more hemoglobins recorded in the first day. Four-hundred-seventy (83.3%) had a normal hemoglobin (≥5th% reference interval) while 94 (16.7%) had anemia, relative risk 3.26 (95% CI, 2.66–4.01) vs. >360,000 neonates from previous reference interval reports. The relative risk of severe anemia (<1st% interval) was 4.96 (3.44–7.16). When the obstetrician identified the abruption as “small” or “marginal” the risk of anemia was insignificant.

Conclusions

Most abruptions do not cause neonatal anemia but approximately 16% do. If an abruption is not documented as small, it is important to surveille the neonate for anemia.

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Fig. 1
Fig. 2: Five-hundred-sixty four neonates born after confirmed placental abruption had one or more blood hemoglobin concentrations recorded during the first 24 h.
Fig. 3: Neonates with two or more blood hemoglobin concentrations reported during the first 10 h after birth are shown with a line connecting the hemoglobin values.

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Acknowledgements

We thank Jillyn Spencer, Office of Research, Intermountain Healthcare, for her expert interactions with the Intermountain Healthcare Institutional Review Board. We also thank Michael W. Varner, MD, Maternal-Fetal Medicine, University of Utah and Stephen D. Minton, MD, Neonatology, Intermountain Healthcare for very helpful discussions.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA

    Sarah M. Tweddell, Timothy M. Bahr, Robin K. Ohls & Robert D. Christensen

  2. Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT, USA

    Timothy M. Bahr, Erick Henry, Jessica M. Page & Robert D. Christensen

  3. Transfusion Medicine, Intermountain Medical Center, Murray, UT, USA

    Sarah J. Ilstrup

Authors
  1. Sarah M. Tweddell
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Contributions

SMT: Conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript. TMB: Data analysis and interpretation, manuscript writing, final approval of manuscript. EH: Collection and assembly of data, manuscript writing, final approval of manuscript. JMP: Collection and assembly of data, manuscript writing, final approval of manuscript. SJI: Collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript. RKO: Data analysis and interpretation, manuscript writing, final approval of manuscript. RDC: Conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript.

Corresponding author

Correspondence to Sarah M. Tweddell.

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Tweddell, S.M., Bahr, T.M., Henry, E. et al. Placental abruption and neonatal anemia. J Perinatol 43, 782–786 (2023). https://doi.org/10.1038/s41372-023-01603-w

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